Diagnosis and treatment of benign breast tumors

Abstract

Introduction. Breast cancer is detected 3-5 times more frequently in the background of benign mammary glands pathology and 30-40 times more frequently in the background of nodular mastopathies with epithelial proliferation of the mammary glands. The early diagnosis and treatment of these tumors is of incontestable actuality. Aim of the study. Assessment of the algorithm for diagnosis and treatment of benign breast tumors in women. Materials and methods. The study represents a retrospective analysis based on the hospital medical records of 80 patients, diagnosed and treated in the department of Mammology no.1 of the Oncological Institute of the Republic of Moldova during January-March 2018. All patients were evaluated in terms of age, risk factors, comorbidities, ultrasound scan and mammography findings, cytology, radiography, histological distribution of the benign processes of the mammary gland (International Classification N 2, Edition II, Geneva, 1984), surgical techniques used, postoperative complications. Results. Thus, 80 women aged 18-65 years with different histological types of benign mammary tumors: fibroadenoma – 34 (42.5%); adenopapiloma cyst – 12 (15%); fibroadenomatoza – 17 (21.25%); lipogranuloma – 16 (20%); phylloid tumors – 1 (1.25%). Women aged 18-35 years – 26 (32.5%) and 36-65 years – 54 (67.5%). The ratio of left/right breast gland lesions was 34/43 (42.5/53.75%), bilateral affection – 3 (3.75%). The following risk factors were identified in 57 (71,25%) patients: abortions – 23 (40,35%); nulliparous – 23 (40,35%); mechanical trauma – 4 (7,01%); pelvic inflammatory disease – 3 (5,26%); uterine myoma 2 (3,5%); hereditary factors – 2 (3,5%). Significant comorbidities were found in 11 patients. All patients underwent ultrasound scan, chest x-ray, mammography in 2 projections, as well as cytological examination. All patients underwent sectoral resections with the emergency frozen-section pathological examination, followed by repeated morphological study after inclusion in paraffin. In 2 cases repeated morphological examination revealed invasive breast carcinomas, which were resected subsequently. There were no any postoperative complications. Conclusions. The diagnosis of benign breast tumors is a complex one and includes several consecutive stages. Surgical procedure depends on the nosological form of tumor and isaccompanied necessarily by urgent frozen-section pathological examination, followed by repeated morphological study after inclusion in paraffin. Key words: benign breast tumor, diagnosis, treatment.